title: Attention bias to threat faces in severe mood dysregulation.
abstract: BACKGROUND
  We used a dot-probe paradigm to examine attention bias toward threat (i.e., angry) and happy face stimuli in severe mood dysregulation (SMD) versus healthy comparison (HC) youth. The tendency to allocate attention to threat is well established in anxiety and other disorders of negative affect. SMD is characterized by the negative affect of irritability, and longitudinal studies suggest childhood irritability predicts adult anxiety and depression. Therefore, it is important to study pathophysiologic connections between irritability and anxiety disorders.
  
  
  METHODS
  SMD patients (N = 74) and HC youth (N = 42) completed a visual probe paradigm to assess attention bias to emotional faces. Diagnostic interviews were conducted and measures of irritability and anxiety were obtained in patients.
  
  
  RESULTS
  SMD youth differed from HC youth in having a bias toward threatening faces (P < .01). Threat bias was positively correlated with the severity of the SMD syndrome and depressive symptoms; degree of threat bias did not differ between SMD youth with and without co-occurring anxiety disorders or depression. SMD and HC youth did not differ in bias toward or away from happy faces.
  
  
  CONCLUSIONS
  SMD youth demonstrate an attention bias toward threat, with greater threat bias associated with higher levels of SMD symptom severity. Our findings suggest that irritability may share a pathophysiological link with anxiety and depressive disorders. This finding suggests the value of exploring further whether attention bias modification treatments that are effective for anxiety are also helpful in the treatment of irritability.
authors.affiliation: Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland; Yale Child Study Center, Yale School of Medicine, Yale University, New Haven, Connecticut.
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Hommer
authors.forename: Allison
authors.initials: A
authors.lastname: Meyer
authors.forename: Joel
authors.initials: J
authors.lastname: Stoddard
authors.forename: Megan E
authors.initials: ME
authors.lastname: Connolly
authors.forename: Karin
authors.initials: K
authors.lastname: Mogg
authors.forename: Brendan P
authors.initials: BP
authors.lastname: Bradley
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Pine
authors.forename: Ellen
authors.initials: E
authors.lastname: Leibenluft
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Brotman
mesh_terms: D000293:Adolescent; D000786:Anger / Q000502:physiology*; D001008:Anxiety Disorders / Q000503:physiopathology*; D001288:Attention / Q000502:physiology*; D002648:Child; D005149:Facial Expression; D005260:Female; D006801:Humans; D007508:Irritable Mood / Q000502:physiology*; D008297:Male; D019964:Mood Disorders / Q000503:physiopathology*; D012720:Severity of Illness Index
keywords: anxiety; biological markers; child and adolescent; cognition; mood disorders